“How Do We Fix Medicine?” was the question asked by Atul Gawande at a recent TED talk.

He points out that the challenge facing medicine has changed.

The challenge is not about improving the ‘components’ of health care, but about building better systems for the delivery of care.

“We are obsessed in Medicine by having the best components. The best drugs, the best technologies, the best specialists. But we don’t think about how it all comes together.”

“There is a wide gap between the best results and the worst results, and the outcomes don’t match the cost. The highest price doesn’t necessarily produce the best health outcome. And that, oddly, is a point of hope. “If to have the best results required you to get the most expensive care, we really would be talking about rationing.” But if you look at successful cases, it’s not quality components, but getting everything to come together in the right way.”

Gawande describes this thought experiment.

“What if you built a car from the very best car parts. Porsche brakes, a Ferrari engine, a volvo body, a BMW chassis. You put it all together and what do you get? A vety expensive pile of junk that does not go anywhere.”

“Making systems work is the great task of my generation of physicians and scientists. But I would go further and say that making systems work — whether in healthcare, education, climate change, making a pathway out of poverty — is the great task of our generation as a whole.”